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Merit Predict
Turn Risk Into Opportunity
Turn Complexity Into Clarity
Turn Insight Into Action
Precision Insights, Proven Outcomes
Merit Predict goes beyond benchmark models to give you a forward-looking view of claims and risk. By analyzing billions of data points, we identify potential high-cost claimants and total group-level claims liability.
This means you can make informed decisions, improve pricing strategies, and take proactive steps to mitigate financial exposure before risks materialize.
Actionable Insights for Tangible Results
Predict High-Risk Members and Their Expected Claims Spend
Identify future catastrophic claimants 12–18 months in advance, allowing you to confidently set competitive premium rates and maintain profitability.
Predict Total First-Dollar Claims by Group
Understand historical spend, total current spend, and total predicted spend distribution with a visibility into high-cost outliers to confidently predict risk.
Optimize Stop Loss Spec Deductible For Each Group
Determine excess claims risk at each specific deductible to ensure you preserve this key relationship
Identify Gaps in Care for Proactive Health Plan Management
Uncover clinical risks across all members and track adherence to key preventive screenings, supporting targeted recommendations that improve outcomes and reduce overall healthcare costs.
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Merit Predict advanced AI/ML model tool is a game-changer in risk management:
Data Flexibility
Uncover insights with or without access to full medical and pharmacy claims data.
Proven Results
Anticipate next year’s catastrophic claimants and total group-level claims spend with accuracy exceeding 80%, empowering you to protect margins, improve win rates, and build trust with clients.
Forward-Looking Accuracy
Predict claims and future risk 12–18 months in advance.
Merit Predict
Turn Risk Into Opportunity
Turn Complexity Into Clarity
Turn Insight Into Action